血浆同型半胱氨酸水平与脑动脉狭窄程度的相关性

目的探讨血浆同型半胱氨酸水平与脑大动脉狭窄程度的相关性。方法选择行全脑数字减影血管造影术(DSA)检查的急性缺血性脑卒中患者269例。根据DSA显示动脉狭窄是否≥50%为依据,分为2组:狭窄组(150例)患者颅内、外脑大动脉至少1支血管狭窄率≥50%;对照组(119例)患者无狭窄或狭窄<50%。检测两组血浆同型半胱氨酸(Hcy)水平,按Hcy值分4个水平(≤11.8μmol/L、11.9-14.1μmol/L、14.2-17.1μmol/L、≥17.2μmol/L)观察血管狭窄≥50%的发生率。进行多因素logistic回归分析。结果狭窄组血浆Hcy水平明显高于对照组。随着血浆Hcy水平升高,脑大动脉粥样硬化狭窄≥50%的发生率逐渐增加(分别为48.6%、53.7%、53.8%、67.2%)。血浆Hcy水平升高是脑大动脉粥样硬化狭窄的独立危险因素(OR=1.071,95%CI:1.004-1.142,P=0.036)。结论 Hcy升高与脑大动脉狭窄程度密切相关,降低血浆Hcy水平与控制其它危险因素同样重要。

Association between plasma level of homocysteine and cerebral large-artery atherosclerosis

Objective To investigate the association between plasma level of homocysteine(Hcy) and severity of largeartery atherosclerotic stenosis in patients with cerebral ischemic stroke.Methods 269 patients with ischemic stroke undergoing cerebral angiography(DSA) were studied.All patients were divided into two groups according to the finding of DSA.Stenosis group(n=150) included patients with large-artery atherosclerotic stenosis(stenosis ≥50%,at least one of large arteries),and control group(n=119) included patients without artery stenosis or mild grade stenosis(stenosis<50%).The levels of Hcy were analyzed in all patients.Results The levels of Hcy in large-artery atherosclerotic stenosis group were higher than that in control group.The ratio of large-artery atherosclerotic stenosis(severity≥50%) was increased gradually with the plasma level of the Hcy(48.6%,53.7%,53.8%,67.2% in different plasma level groups respectively).Multivariable stepwise logistic regression model showed that plasma Hcy level was an independent risk factor of large artery atherosclerotic stenosis(OR=1.071,95%CI:1.004-1.142,P =0.036).Conclusions The elevated of plasma Hcy was significantly correlated with the severity of cerebral large-artery atherosclerosis.Reduce plasma level of Hcy and control other risk factors were equally important.